Glitch Stalls Retrofitting of Hospitals

A hiring freeze has slowed the state office that reviews projects. Yet $40 million is available for staffing.

Hospitals throughout the state are on the cusp of a construction boom, rebuilding and retrofitting seismically unsafe buildings to meet a mandated 2008 deadline.

But the state office that oversees hospital building plans doesn't have enough people to review the projects.

The staffing shortage at the Office of Statewide Health Planning and Development, brought about by a hiring freeze, has resulted in building delays of up to a year. It also has meant millions of dollars in extra construction costs for hospitals and millions more in lost wages for communities.

"There are $7 billion we are trying to contribute to the economy and it seems ironic to us, at a time the economy needs it, that we're having trouble doing it," said Bob Eisenman, a spokesman for Kaiser Permanente's national facilities services.

"We are really worried. We're talking about 19 new hospitals in 10 to 15 years. That's not even counting the myriad ongoing, smaller improvements in renovation projects."

The irony, hospital officials say, is that staff positions at the state health planning office are entirely paid for by hospitals, not by the state. Hospitals pay 1.64% of their total construction costs into a fund administered by the office, which has grown to $40 million. By law, that money must be used to hire employees to review hospital construction projects. But, because of a state hiring freeze, it can't be touched.

Assemblyman Dario Frommer (D-Los Feliz), has introduced a bill that would exempt those positions from the freeze and any further cutbacks until Jan. 1, 2013. The bill also would authorize the health planning office to add hospital-funded positions.

"This delay is unconscionable," Frommer said. "I think every constituent in California wants to know that the facility they're visiting is going to be safe during an earthquake -- they expect that. Also, this program is funded by fees, so we're not taking money out of the general fund."

The state Department of Finance, however, opposes the bill, arguing in part that the bill attempts to usurp the authority of the executive branch and encourages the growth of government.

The debate arises as hospitals are hustling to evaluate and retrofit their buildings by 2008, a deadline set by state law. That law was expanded in the wake of the 1994 Northridge earthquake, when 23 hospitals sustained more than $3 billion in damage and were forced to suspend some or all services. Overall, hospitals are expected to spend $14 billion on construction and improvements, industry officials said. Some hospitals may request extensions, which will be granted by the state on a case-by-case basis.

In the past year, the health planning office's workload has doubled to about 4,000 projects. The number of projects submitted for review next year is expected to increase significantly. Meanwhile, office staffing has dropped from 186 people to 156.

"Along with the amount of work, the nature of the projects is changing. What we're seeing now is a lot more large job replacement buildings and towers," said Kurt Schaefer, deputy director of the office's facilities development division. "Those can take significantly more time."

Childrens Hospital Los Angeles, for example, has started a $300-million rebuilding program and state approvals are taking almost twice as long as they have in the past, said construction director John Sottile. "We submitted a plan check in March and they did not begin review of the documents until July," he said.

The process is much swifter in many other states, hospital officials say.

"Back in Arizona, from which I came, the process was more a review by each and every city in terms of compliance with building codes," said Rob Curry, president of O'Connor Hospital in San Jose. "That process took an average three to four months."

The backlog in California's health planning office has not only affected earthquake-related projects, but the gamut of construction proposed by hospitals for any reason.

O'Connor submitted plans in December 2002 to double the capacity of its emergency room, officials said. The hospital received partial approval in July of this year and is still waiting for the green light on its structural plans.

"If you look at it in terms of hours, we virtually have closed the emergency department two days a month," Curry said. "What that means is long waits and perhaps compromised care" as hospitals throughout the area struggle to accommodate the extra patients.

Another long-delayed project is Kaiser Permanente's hospital in Santa Clara. Kaiser is planning to replace the hospital with a new, $440-million facility.

It submitted plans for approval in April 2002, estimating that the office would need a year to complete its review and that the new hospital would be ready to open in November 2003. Kaiser is still waiting, spokesman Eisenman said.

"The impact of that, we believe, is there will be $2 million to $3 million in added constructions costs," he said. "Also, had we gotten the approval in 12 months, we would have added 100 to 200 jobs this year."